| 17657324 |
Sepulveda MA, Bello HT, Dominguez MY, Mella SM, Zemelman RZ, Gonzalez GR: [Molecular identification of aminoglycoside-modifying enzymes among strains of Enterococcus spp. isolated in hospitals of the VIII Region of Chile]. Rev Med Chil. 2007 May;135(5):566-72. Epub 2007 Jul 9.
BACKGROUND: Infectious diseases produced by Enterococcus spp, must be treated with a synergistic combination between a penicillin and an aminoglycoside. High level resistance to aminoglycosides is a serious therapeutic problem, since it predicts the loss of synergistic activity of this antimicrobial combination. AIM: To investigate the presence of genes encoding aminoglycoside-modifying enzymes (AMEs) among strains of Enterococcus spp with high level of resistance to aminoglycosides. MATERIAL AND METHODS: The genes encoding some of the AMEs were investigated among 305 aminoglycoside-resistant strains of Enterococcus spp isolated in hospitals of the VIII region of Chile, by dot blot hybridization and Polymerase Chain Reaction (PCS). RESULTS: High level resistance to some aminoglycosides was observed in 104 strains (34.1 %) and 93 of these harbored at least one of the genes encoding the investigated AMEs. Three genes were detected: aac (6) Ie-aph (2") Ia (14.8%) encoding for the enzyme AAC (6) Ie-APH (2") Ia (resistance to all aminoglycosides, except streptomycin); aph (3) IIIa (26%), and ant (6) la (28.5%) encoding for the phosphorylating enzymes APH (3) Ilia (resistance to kanamycin, amikacin and neomycin), and ANT (6)-la (resistance only to streptomycin), respectively. None of the strains harbored the gene ant (4) which encode for the enzyme ANT (4). CONCLUSION: The low frequency of strains harbouring the bifunctional enzyme (<15%), conferring an extended resistance profile to aminoglycosides, allows us to propose the empirical use of aminoglycoside-aminocyclitols, associated to a penicillin, in the treatment of serious infections produced by species of enterococci. |
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